Organization
DAY TO DAY RESPITE AND REHAB
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA S JOHNSON (DIRECTOR)
(936) 371-1536
Entity
Organization
Contact information
Practice address
401 HOUSTON ST, NACOGDOCHES, TX 75961-4465
(936) 371-1536
Mailing address
401 HOUSTON ST, NACOGDOCHES, TX 75961-4465
(936) 371-1536
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
01/30/2020
Last updated
01/30/2020
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